宿主免疫功能低下并发肺结核CT表现特征

CT Features of Pulmonary Tuberculosis Complicated by Low Immune Function Patients

目的:研究宿主免疫功能低下并发肺结核的CT影像表现特征。方法:搜集38例免疫功能低下并发肺结核患者的临床及CT影像资料,从病变类型、分布、大小、形态、性质以及淋巴结改变等方面进行分析。结果:免疫功能低下并发肺结核患者的CT影像表现以浸润型肺结核为主,病变广泛分布,主要表现为实变阴影(38/38,100%)、多发性结节(21/38,55%)、空洞(16/38,42.1%)、淋巴结改变(11/38,28.9%),多伴有肺气肿、纤维条索硬化、钙化、支气管狭窄或扩张、胸膜改变等征象。结论:宿主免疫功能低下并发肺结核的CT影像学表现复杂多样、多变,发病部位及CT征象均不典型;病变范围广,多性质病灶共存且易扩展播散,肺受损严重、预后差为其特点。CT检查结合病史及临床资料对明确诊断有积极意义。

objective： To analyze CT features of pulmonary tuberculosis complicated by low immunefunction patients. Methods：38 cases of confirmed CT images of pulmonary tuberculosis in immunocompromised patients were collected, anglicizing from the lesion types, distribution, size, configurations of focus, property and lymphatic pathological changes, etc. Results ： the most of CT images of pulmonary tuberculosis in immunocompromised patients caught infiltrative pulmonary tuberculosis, the lesions distributed widely, the consolidation（38/38, 100%）, nodules（21/38, 55%）, cavitations（16/38, 42.1%）, lymphatic pathological changes（11/38, 28.9%） were typical manifestation, which accompanied emphysema, hardening and calcified fibrous bands, the stenosis and dilatation of bronchus and pleural changes, etc. Conclusion： the CT images of pulmonary tuberculosis complicated by low immune function patients are complex and changeable, the features of which include that the pathogenic location and CT symptom are both atypical, the extent of disease is wide, the multi-character focus coexist and spread easily, the lung is damaged seriously and the prognosis is poor. CT diagnosis with medical history and clinical material attach positive significance to clear diagnosis.